Mixture of 50% Nitrous oxide IP by volume and 50% Oxygen IP by volume

ENTONOX® is an analgesic, with a very rapid onset of action and is quickly eliminated from the body. It is widely used by midwives, hospitals, and emergency medical services.

It is only used for short-term procedures for pain management, including but not limited to:

• Labor Pain Management
• Acute trauma
• Tooth extraction and other brief procedures in dental work
• Wound and burn dressings, wound debridement, and suturing
• Fractures and joints Operation
• Colonoscopy
• Venipuncture

Method of Administration:

ENTONOX® is a self-administered gas mixture, administered by the patient, under the supervision of a trained Hospital Staff. The gas mixture is administered through a Demand valve Apparatus which releases gas only when inhaled or with negative pressure. ENTONOX® can be commenced from the First stage of labor (3cms cervical dilatation) and can be continued till the bearing down the stage. The patient should ensure synchronizing the pain and analgesic effect to obtain effective analgesia. Since it is self-administered, the risk of overdose is minimized as the patient drops the mask or it slips out of the patient’s hand in case of excess inhalation of the product. When a patient is not getting contraction or not inhaling, the patient should be advised to hold the demand valve away from their face.

ENTONOX® In Obstetrics: 

ENTONOX® is an ideal analgesic in obstetrics as the pain during contractions is intermittent and inhalations can be synchronized with the contractions. With intermittent inhalation in obstetrics, there is a minimal effect on the cardiovascular, respiratory or neurological system of the mother and the fetus. To get desired analgesic effect, patients should be advised to Inhale and exhale deeply, and uniformly. The patient should be taught synchronizing at the beginning of the first stage when the contractions are not frequent. ENTONOX® usage can be continued till the bearing downstage, and after delivery, can be continued during cleaning and suturing.

ENTONOX® should not be used for more than 24 hours without monitoring peripheral blood for features of megaloblastic anemia and leukopenia.

Advantages of ENTONOX®:

• Self- administered: Possibility of over dosage is ruled out as the mask slips out of the Patient's hand when they get drowsy.
• Ideal properties of Quick Onset (20 sec), Short Duration (60sec), and Rapid recovery. Suitable for Labor pain as labor pains are intermittent and of short duration.

• Can be used as an adjuvant with other opioids or oral analgesics.
• Verbal contact with the patient remains intact allowing greater cooperation throughout the procedure.
• Compared with Epidural, ENTONOX® is Non-Invasive ensuring analgesia without any rupture or damage to the spinal cord.
• Can be administered under the supervision of trained medical staff. Other analgesics require the presence of a trained anesthetist throughout the procedure.
• No remarkable effect on the Cardiovascular, Respiratory & Endocrine functions of the mother and the fetus.
• ENTONOX® can be used in conjugation with epidural analgesia.
• ENTONOX® is not metabolized in the kidneys or liver and is excreted out of the lungs as N2O.
• Along with the analgesic effect, 50% Oxygen rejuvenates the mother and the fetus.
• Easy and convenient to use, with low cost of maintenance.
• Safe and well-proven analgesic in Labor pain management.
• Economical and affordable for all classes of the society.